antiplatelets

Samahjabi's picture

Effect of Prestroke Use of Angiotensin-Converting Enzyme Inhibitors Alone Versus Combination with Antiplatelets and Statin on Ischemic Stroke Outcome

Journal Title, Volume, Page: 
Clinical Neuropharmacology: November/December 2011 - Volume 34 - Issue 6 - p 234–240 doi: 10.1097/WNF.0b013e3182348abe
Year of Publication: 
2012
Authors: 
Hassan, Yahaya
Al-Jabi, Samah
Current Affiliation: 
Department of Pharmacy, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
Aziz, Noorizan Abd
Looi, Irene MBBS
Zyoud, Sa’ed
Preferred Abstract (Original): 

Background: Angiotensin-converting enzyme inhibitors (ACEIs), antiplatelets (APs), and statin are increasingly being prescribed for ischemic stroke prevention.
Objectives: The objective of the study was to examine whether previous combination therapy of ACEI with AP and/or statin has additive effect compared with ACEI alone on functional outcome after ischemic stroke. Furthermore, factors associated with improving functional outcome were investigated.
Methods: Ischemic stroke patients attending a Malaysian hospital in 2008 were categorized according to Barthel Index at discharge. Favorable outcome was defined as Barthel Index of 75 or greater. Data included demographic information, clinical characteristics, and previous medications with particular attention to ACEI, AP, and statin.
Results: Overall, 505 patients were included. Variables associated with good functional outcome were younger age (P = 0.002), first-ever attack (P = 0.016), lacunar (P = 0.015) or posterior circulation infarct stroke subtype (P = 0.034), minor Glasgow Coma Scale (P < 0.001), and previous use of ACEI alone or combined with AP and/or statin (P = 0.002). Using ACEI alone as the reference for ACEI + AP, ACEI + statin, or ACEI + AP + statin combinations, there was no significant difference among combinations on improving functional outcome (P = 0.852)
Conclusions: Prestroke use of ACEI either alone or combined with AP and/or statin was associated with better functional outcome. Previous use of ACEI in combination with AP and/or statin did not significantly differ from ACEI alone in their effect on outcome. Our study provides a potential rationale for optimizing the use of ACEI among individuals at risk of developing ischemic stroke. 

saedzyoud's picture

Effect of Prestroke Use of Angiotensin-Converting Enzyme Inhibitors Alone Versus Combination With Antiplatelets and Statin on Ischemic Stroke Outcome

Journal Title, Volume, Page: 
Clinical Neuropharmacology; DOI: 10.1097/WNF.0b013e3182348abe
Year of Publication: 
2011
Authors: 
Yahaya Hassan
Department of Pharmacy Practice, Faculty of Pharmacy, Universiti Tekno- logi MARA (UiTM), Puncak Alam Campus, Bandar Puncak Alam, Selangor Darul Ehsan
Samah W. Al-Jabi
Clinical Pharmacy Program, School of Pharmaceutical Sci- ences, Universiti Sains Malaysia (USM), Penang, Malaysia
Noorizan Abd Aziz
Department of Pharmacy Practice, Faculty of Pharmacy, Universiti Tekno- logi MARA (UiTM), Puncak Alam Campus, Bandar Puncak Alam, Selangor Darul Ehsan
Irene Looi
Clinical Re- search Centre, Hospital Pulau Pinang
Sa’ed H. Zyoud
Department of Pharmacy, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
Current Affiliation: 
Department of Pharmacy, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
Preferred Abstract (Original): 

Background: Angiotensin-converting enzyme inhibitors (ACEIs), antiplatelets (APs), and statin are increasingly being prescribed for ischemic stroke prevention.
Objectives: The objective of the study was to examine whether previous combination therapy of ACEI with AP and/or statin has additive effect compared with ACEI alone on functional outcome after ischemic stroke. Furthermore, factors associated with improving functional outcome were investigated.  Methods: Ischemic stroke patients attending a Malaysian hospital in 2008 were categorized according to Barthel Index at discharge. Favorable outcome was defined as Barthel Index of 75 or greater. Data included demographic information, clinical characteristics, and previous medications with particular attention to ACEI, AP, and statin.
Results: Overall, 505 patients were included. Variables associated with good functional outcome were younger age (P = 0.002), first-ever attack (P = 0.016), lacunar (P = 0.015) or posterior circulation infarct stroke subtype (P = 0.034), minor Glasgow Coma Scale (P < 0.001), and previous use of ACEI alone or combined with AP and/or statin (P = 0.002). Using ACEI alone as the reference for ACEI + AP, ACEI + statin, or ACEI + AP + statin combinations, there was no significant difference among combinations on improving functional outcome (P = 0.852).
Conclusions: Prestroke use of ACEI either alone or combined with AP and/or statin was associated with better functional outcome. Previous use of ACEI in combination with AP and/or statin did not significantly differ from ACEI alone in their effect on outcome. Our study provides a potential rationale for optimizing the use of ACEI among individuals at risk of developing ischemic stroke.

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